Trends in Hospitalizations for Adults With Congenital Heart Disease in the U.S.

OBJECTIVES The purpose of this study was to better define the epidemiology of hospitalizations for adults with congenital heart disease (ACHD) in the U.S. BACKGROUND There is a growing population of ACHD as the result of advances in pediatric care and diagnostic testing. METHODS We used nationally representative data from the 1998 to 2005 Nationwide Inpatient Sample to identify patients > or =18 years of age admitted to an acute care hospital with an International Classification of Diseases-9th Revision code designating a CHD diagnosis. National estimates of hospitalizations and total hospital charges by year were calculated. RESULTS The number of ACHD hospitalizations increased 101.9% from 35,992 +/- 2,645 in 1998 to 72,656 +/- 5,258 in 2005. During this period, the annual number of admissions grew for both simple (19,448 +/- 1,614 to 44,707 +/- 3,644) and complex (12,507 +/- 1,172 to 19,973 +/- 1,624) diagnoses. The percentage of admissions originating in the emergency department (41.7 +/- 0.8%) or involving cardiac surgery (17.7 +/- 0.7%) remained stable during the study period. The average patient age (52.3 +/- 0.8 years to 53.8 +/- 0.6 years, p < 0.0001) and proportion of patients with > or =2 medical comorbidities (23.3 +/- 0.9% to 33.0 +/- 0.7%, p < 0.0001) increased. Mean hospital charges per hospitalization increased 127% from 19,186 +/- 803 to 43,496 +/- 2,166 US dollars, and the estimated total national charges for these hospitalizations increased 357% from 691 million US dollars in 1998 to 3.16 billion US dollars in 2005 (in inflation-adjusted 2005 dollars). CONCLUSIONS The number of hospital admissions for ACHD in the U.S. more than doubled between 1998 and 2005. Hospital charges attributable to these admissions have grown even more dramatically.